Provider Demographics
NPI:1073563482
Name:DUSEK, DENNIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:DUSEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:12639 OLD TESSON RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2786
Practice Address - Country:US
Practice Address - Phone:314-849-0311
Practice Address - Fax:314-849-4423
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2A15207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO43011OtherGROUP HEALTH PLAN
MO201356607Medicaid
MO200021647OtherRAILROAD MEDICARE
MO23136OtherBLUE CROSS BLUE SHIELD
MO0900009OtherUNITED HEALTH CARE
MO2219812002OtherCIGNA
MO100856OtherHEALTHLINK
MO4000270OtherAETNA